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EASTERN SERVICES & CAMP SIMON LLC NPI 1902173370


NPI Information

NPI: 1902173370
Provider Name: EASTERN SERVICES & CAMP SIMON, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
115 BRIDGE ST
SUITE C
EAST WINDSOR, CT
ZIP 06088
Phone: (860) 254-5127
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EASTERN SERVICES & CAMP SIMON, LLC is a professional counselor in East Windsor, CT. EASTERN SERVICES & CAMP SIMON, LLC NPI is 1902173370. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

115 BRIDGE ST
SUITE C
EAST WINDSOR, CT
ZIP 06088-547
Phone: (860) 254-5127
Fax: (860) 254-5254

The provider's authorized official is Maly Phimvongsa .
The authorized official title is Director and has the following contact phone number (860) 254-5127.

The enumeration date for this NPI number is 11/29/2011 and was last updated on 2/11/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessional001470CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004257053MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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